Individual provider Active NPI

Kristyn Noelle Peters, OTR/L

  • Occupational Therapist
  • Hampton, VA
National Provider Identifier
1366159832
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119008542 Issued in VA
Practice address
593 Aberdeen Rd
Hampton, VA 23661-1332
Phone
(757) 455-5000
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119008542 VA Primary

Addresses

Primary practice location

593 Aberdeen Rd
Hampton, VA 23661-1332

Mailing address

5620 Fire Opal Dr Apt 210
Virginia Beach, VA 23455-5554
Phone (757) 560-3251

Other practice location 1

5604A Virginia Beach Blvd
Virginia Beach, VA 23462-5681
Phone (757) 455-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118000255 VA Practitioner - Occupational Therapist in Private Practice 7719355072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JP Therapy LLCGroup PAC ID 6709192503, 28 clinicians

Practice addresses (Care Compare)

5604 Virginia Beach Blvd
Suite 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119008542VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JP Therapy, LLC CurrentSince Nov 14, 2022 Accepting new patients

Locations

593 Aberdeen Rd
Hampton, VA 23661
Phone (757) 825-1100

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462
Phone (757) 319-4142

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1366159832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 FIRE OPAL DR APT 210",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555554",
            "telephone_number": "757-560-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 ABERDEEN RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236611332",
            "telephone_number": "757-455-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5604A Virginia Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234625681",
            "country_code": "US",
            "telephone_number": "757-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KRISTYN",
        "middle_name": "NOELLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.